Organization · NPI-2

Intermountain Neurology PC

Psychiatry & Neurology, Neurology · Bozeman, MT

NPI number1457486276
StatusActive
Last updated in NPPESNov 13, 2009

Details

NPI
1457486276
Entity type
Organization (NPI-2)
Legal business name
Intermountain Neurology PC
Organization subpart
No
Enumeration date
Feb 22, 2007
Last updated
Nov 13, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2084N0400X Psychiatry & Neurology, Neurology10470MTYes

Practice location

650 Ferguson Ave
Suite 1
Bozeman, MT 59718-6518

Phone 406-922-2770 · Fax 406-922-2771

Mailing address

650 Ferguson Ave
Suite 1
Bozeman, MT 59718-6518

Phone 406-922-2770 · Fax 406-922-2771

Authorized official

Sherry A Reid
Owner
4069222770

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